Marcus Allen Willingham

Primary specialty

PharmacistTaxonomy code 183500000X

License

S025534 Issued in AZ

Practice address

554 W Baseline Rd
Mesa, AZ 85210-6019

Phone

(480) 969-6234

NPI assigned

Oct 28, 2021

Last updated

Oct 28, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Smiths Food & Drug Centers Inc

  dba Frys Food and Drug

  • Community/Retail Pharmacy
  • Mesa, AZ
  • NPI 1760424345
  NPD (past)
• Smith's Food & Drug Centers Inc

  dba Smith's Pharmacy #303

  • Community/Retail Pharmacy
  • Henderson, NV
  • NPI 1881585248
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1225792989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2352 W ALTA VISTA RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850415326",
            "telephone_number": "619-288-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 W BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106019",
            "telephone_number": "480-969-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLINGHAM",
        "first_name": "MARCUS",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "AZ",
            "license": "S025534",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S025534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Ann Williams, REGISTERED NURSE
• Tyler Williams
• Vergal Serafino Williams
• Brad P. Williamson, D.C.
• Nikita Rae Williamson, M.S., SLP-CF
• Chad Riley Willis Jr., LPC
• Jay Ronald Willis, DC
• John Willis
• Kathy Renee Willis
• Lashawn R Willis

• Pharmacist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Pharmacist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.